Exam I - Bipolar Drugs Flashcards
1
Q
Drug List
A
Lithium
Olanzapine
Valproic Acid
Lamotrigine
2
Q
Acute Mania
Drugs of Choice
A
- Antipsychotics (olanzipine, haloperidol)
- IV benzos
- Anticonvulsants (valproate)
3
Q
Maintenance
Drugs of Choice
A
- Lithium Carbonate
- Anticonvulsants (valproate, lamotrigine)
- Antipsychotics (olanzapine)
4
Q
Depression
Co-Rx
A
-Mood stabilizer (lithium) + ADD
5
Q
Lithium Mechanism (theory)
A
- IP3 inhibitor
- glycogen synthase kinase-3 inhibitor
6
Q
Lithium
Indications
A
- both poles of bipolar disorder
- depression
- schizoaffective d/o adjunct to antipsychotics
- NOT very effective for acute mania
7
Q
Lithium
ADME
A
- 80% reabsorbed
- narrow tx window (blood level monitoring)
- slow release preparations available
8
Q
Lithium
Drug-Drug
A
- increase Na excretion>decr Li excretion (diuretics)
- dehydration, NSAIDs, ACEI incr Li
- mannitol, acetazolamide, theophylline decr Li
9
Q
Lithium
Adverse
A
- fatigue, GI, remor, edema, hypothyroid
- acne, psoriasis
- polydipsia, polyuria, diabetes insipidus
10
Q
Lithium
Toxicity
A
- confusion, ataxia, HoTN, arrhythmia, convulsions, coma
- supportive tx, dialysis, osmotic diuretics
11
Q
Bipolar II Tx
A
-anticonvulsants (lamotrigine, valproate)
12
Q
Valproate
A
-useful for mixed and rapid cycling
13
Q
Lamotrigine
A
- good for preventing depressive episodes
- risk of Stevens-Johnson rash
14
Q
Antipsychotics
A
- good for acute mania
- “equivalent to lithium” - FDA
- weight gain, DM II
